Promoting healthy weight by finding cost-effective, evidence-based strategies

The Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Project at the Harvard T.H. Chan School of Public Health is working to help promote healthy weight for kids by identifying strategies that are both cost-effective and have strong evidence for impact on health.

Adults and children in the U.S. consume more calories from foods and beverages than they are expending. Over the past few decades, this trend has created an obesity epidemic.

Identifying what works to reduce childhood obesity has become a priority for public health researchers, policymakers, and the general public.

Little attention has been paid, however, to identifying solutions that not only work, but that deliver the best results for the dollars invested. Some strategies can even be cost-saving. CHOICES is focused on identifying these cost-effective strategies.

Rigorous process, unique focus

The CHOICES research team has generated cost-effectiveness estimates for more than 40 of the most widely promoted or implemented strategies to reduce childhood obesity, many of which have never been fully evaluated for comparative- or cost-effectiveness.

Learn more about our methods

We know what works and where

Our research focuses on strategies within four key settings:

  • School: Strategies in the school sector involve policies and programs that impact formal educational settings for children, where students learn under the direction of teachers.Typically this sector refers to elementary and secondary educational spaces for children in kindergarten through 12th grade.
  • Early Care and Out-of-School Time: Strategies in the early care and education and out of school time sector involve policies and programs that impact formal programs for infants, toddlers and preschoolers (often referred to as early care and education) and formal programs for school age children during out-of-school time, such as afterschool and before school care and summer programs.
  • Clinical: Strategies in the clinical sector involve policies and programs that impact children either in medical care settings (such as pediatric primary care offices, hospitals or community health centers) or in connection with medical care providers (for example referrals from primary care providers to group nutrition and physical activity counseling programs). These strategies will include treatment strategies for children with obesity.
  • Community: Strategies in the community sector involve policies and programs that often involve a range of actions by various entities, like revenue/finance (taxes), health agencies (inspectional services), nutrition assistance programs (like SNAP, WIC) and transportation/planning (engineering changes to allow for bike lanes). Multi-sector strategies will often be included in this group.